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Volume 177 , 1 August 2017, Pages 268-276 Reward-related frontostriatal activity and smoking behavior among adolescents in treatment for smoking cessation Author links open overlay panel Kathleen A.Garrisona One of the first longitudinal fMRI studies of smoking cessation treatment in adolescents. Adolescents show increased non-drug reward-related brain activity pre- to post-treatment. Increases in reward-related brain activity were associated with smoking abstinence. Tobacco use is often initiated during adolescence and continued into adulthood despite desires to quit. A better understanding of the neural correlates of abstinence from smoking in adolescents may inform more effective smoking cessation interventions. Neural reward systems are implicated in tobacco use disorder, and adolescent smokers have shown reduced reward-related ventral striatal activation related to increased smoking. The current study evaluated nondrug reward anticipation in adolescent smokers using a monetary incentive delay task in fMRI pre- and post- smoking cessation treatment (n = 14). This study tested how changes in neural responses to reward anticipation pre- to post-treatment were related to reduced smoking. An exploratory analysis in a larger sample of adolescents with only pre-treatment fMRI (n = 28) evaluated how neural responses to reward anticipation were related to behavioral inhibition and behavioral activation scales. Adolescent smokers showed pre- to post-treatment increases in reward anticipation-related activity in the bilateral nucleus accumbens and insula, and medial prefrontal cortex, and greater increases in reward anticipation-related activity were correlated with larger percent days of smoking abstinence during treatment. These findings suggest that reduced smoking during smoking cessation treatment is associated with a “recovery of function” in frontostriatal responses to nondrug reward anticipation in adolescent smokers, although comparison with a developmental control group of adolescent nonsmokers is warranted.
According to Framework Convention on Tobacco Control (FCTC), excise duty should constitute at least 70% of the final retail price. The government had been quick to implement excise tax that constitutes roughly half of retail price today. However, the same speed did not apply to FCTC’s guidance on tobacco control programmes. The revenue collected from cigarette sales was used to finance local smoking cessation programmes like mQuit . From the year 2016 to 2019, the Health Ministry targets to help 390,000 smokers quit the habit. The targeted quantity of smokers is only equivalent to 7.8% of the current smoking population, and resources allocated are evidently insufficient. Malaysia’s current minimum legal age for smoking is 18 . Countries like Singapore and Sri Lanka have made progress to raise the age requirement to 21 while Malaysia is still debating on its 2018 tobacco bill . Although the government has designated non-smoking zones , there seemed to be negligible enforcement and issuance of fines. Is Malaysia’s government just too incompetent?
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Of the 4.7 million smokers here, most started before the age of 18, with 25% before the age of 10. A study on juvenile delinquency carried out by the Malaysian Crime Prevention Foundation showed that cigarette smoking offence (87%) is the top of the seven offences among delinquent children. Making cigarettes affordable for our youths and children will clearly result in far greater repercussions than we can imagine. 3. Every year, more than 20,000 Malaysians are killed by tobacco-related diseases. Studies show that more men and women die in Malaysia from tobacco-related diseases than on average in middle-income countries. What is more alarming is that you don’t need to be a smoker to be at risk. The Global Adult Tobacco Survey 2012 on Malaysia revealed that four out of 10 adults were found to be exposed to secondhand smoke at home (7.6 million adults), and four out of 10 were found to be exposed to secondhand smoke indoors at their workplace (2.3 million adults). Among those adults who visited a restaurant in the past 30 days, seven out of 10 would have been exposed to secondhand smoke (8.6 million adults). 4.
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